Factors affecting sphincter-preserving resection treatment for patients with low rectal cancer

Sun, Zhenqiang; Yu, Xianbo; Wang, Haijiang; Ma, Ming; Zhao, Ze-liang; Wang, Qisan

doi:10.3892/etm.2015.2552

Cited by 12 publications

(16 citation statements)

References 35 publications

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“…At present, there are four types of anus-preserving operation for ultra-low rectal cancer: ultra-low anterior resection (Dixon operation), intersphincter resection (ISR operation) [27], coloanal anastomosis (Parks operation), and local transanal resection. Among them, ISR [28] is a relatively mature anus-preserving operation, but because it needs to remove part or all of the internal anal sphincter, the postoperative anal function of patients is not good [29]. Therefore, the research on other more effective anus-preserving methods has never stopped.…”

Section: Discussionmentioning

confidence: 99%

Anal function and quality of life analysis after laparoscopic modified Parks for ultra-low rectal cancer patients

Ding

Chen

et al. 2020

World J Surg Onc

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Background: To assess postoperative anal function and quality of life of ultra-low rectal cancer patients treated by laparoscopic modified Parks surgery. Methods: From February 2017 to March 2019, 114 patients with ultra-low rectal cancer above T2 were treated respectively with ultra-low anterior resection (Dixon), modified coloanal anastomosis (modified Parks), and Miles according to the preoperative stage and anastomotic position. The postoperative anal function and Fecal Incontinence Quality of Life Scale (FIQL) of each patient were collected and synthetically analyzed. Results: Compared with the Dixon group, the postoperative anal function and FIQL in the Parks group were poor at the early stage. However, from 6 to 12 months after surgery, the scores of anal function and FIQL in the Parks group were similar to those in the Dixon group (P > 0.05). Compared with the Miles group, the FIQL of the two groups were similar in the early postoperative stage. However, with the passage of time, from 3 to 9 months after surgery, the four domains of FIQL in the Parks group were higher than those in the Miles group successively (P < 0.05). Conclusions: Laparoscopic modified Parks is a safe, effective, and economical anus-preserving surgery. Although its early anal function and FIQL were poor, it could gradually recover to the similar level as Dixon. Moreover, it can save the anus and obtain a better postoperative quality of life for some patients who previously could only undergo Miles.

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Section: Discussionmentioning

confidence: 99%

Anal function and quality of life analysis after laparoscopic modified Parks for ultra-low rectal cancer patients

Ding

Chen

et al. 2020

World J Surg Onc

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“…The distance of the tumor to the anal verge is an important parameter predictive for sphincterpreserving surgery, and this has been extensively studied [5,[18][19][20][21][22]. Tumors staged as T2-3, N0 in which a distal bowel clearance >1 cm does not involve a major part of the external anal sphincter, a TME and intersphincteric distal dissection with hand-sewn colo-anal anastomosis is recommended [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Clinical parameters predictive for sphincter-preserving surgery and prognostic outcome in patients with locally advanced low rectal cancer

Partl

Magyar

Hassler

et al. 2020

Preprint

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Background Although controversial, there are data suggesting that clinical parameters can predict the probability of sphincter preserving procedures in rectal cancer. The purpose of this study was to investigate the association between clinical parameters and the sphincter-preserving surgery rate in patients who had undergone neoadjuvant combination therapy for advanced low rectal cancer. Methods In this single center study, the charts of 540 patients with locally advanced rectal cancer who had been treated with induction chemotherapy-and/or neoadjuvant concomitant radiochemotherapy (nRCT) over an 11-year period were reviewed in order to identify patients with rectal cancer ≤6 cm from the anal verge, who had received the prescribed nRCT only. Univariate and multivariate analyses were used to identify pretreatment patient- and tumor associated parameters correlating with sphincter preservation. Survival rates were calculated using Kaplan-Meier analyses.Results 280 of the 540 patients met the selection criteria. Of the 280 patients included in the study, 158 (56.4%) underwent sphincter-preserving surgery. 164 of 280 patients (58.6%) had a downsizing of the primary tumor (ypT < cT) and 39 (23.8%) of these showed a complete histopathological response (ypT0 ypN0). In univariate analysis, age prior to treatment, Karnofsky performance status, clinical T-size, relative lymphocyte value, CRP value, and interval between nRCT and surgery, were significantly associated with sphincter-preserving surgery. In multivariate analysis, age (hazard ratio (HR)=1.05, CI95%: 1.02-1.09, p=0.003), relative lymphocyte value (HR=0.94, CI95%: 0.89-0.99, p=0.029), and interval between nRCT and surgery (HR=2.39, CI95%: 1.17-4.88, p=0.016) remained as independent predictive parameters. A significant longer disease-free (p =0.009) and overall survival (p =0.004) were observed in the sphincter-preserving surgery group. Conclusions These clinical parameters can be considered in the prognostication of sphincter-preserving surgery in case of low rectal adenocarcinoma. More future research is required in this area.

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“…Since the tumor localization is an independent predictive parameter for the probability of a sphincterpreserving operation, we limited our evaluation to patients with low rectal cancer [5,[17][18][19][20][21]. In this localization the available data on other predictive parameters is still very sparse.…”

Section: Discussionmentioning

confidence: 99%

Clinical parameters predictive for sphincter-preserving surgery and prognostic outcome in patients with locally advanced low rectal cancer

Partl

Magyar

Hassler

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Although controversial, there are data suggesting that clinical parameters can predict the probability of sphincter preserving procedures in rectal cancer. The purpose of this study was to investigate the association between clinical parameters and the sphincter-preserving surgery rate in patients who had undergone neoadjuvant combination therapy for advanced low rectal cancer. Methods In this single center study, the charts of 540 patients with locally advanced rectal cancer who had been treated with induction chemotherapy-and/or neoadjuvant concomitant radiochemotherapy (nRCT) over an 11-year period were reviewed in order to identify patients with rectal cancer ≤6 cm from the anal verge, who had received the prescribed nRCT only. Univariate and multivariate analyses were used to identify pretreatment patient- and tumor associated parameters correlating with sphincter preservation. Survival rates were calculated using Kaplan-Meier analyses. Results 280 of the 540 patients met the selection criteria. Of the 280 patients included in the study, 158 (56.4%) underwent sphincter-preserving surgery. 164 of 280 patients (58.6%) had a downsizing of the primary tumor (ypT < cT) and 39 (23.8%) of these showed a complete histopathological response (ypT0 ypN0). In univariate analysis, age prior to treatment, Karnofsky performance status, clinical T-size, relative lymphocyte value, CRP value, and interval between nRCT and surgery, were significantly associated with sphincter-preserving surgery. In multivariate analysis, age (hazard ratio (HR)=1.05, CI95%: 1.02-1.09, p=0.003), relative lymphocyte value (HR=0.94, CI95%: 0.89-0.99, p=0.029), and interval between nRCT and surgery (HR=2.39, CI95%: 1.17-4.88, p=0.016) remained as independent predictive parameters. A significant longer disease-free (p =0.009) and overall survival (p =0.004) were observed in the sphincter-preserving surgery group. Conclusions The findings of our study in a consistently treated cohort of 280 patients with advanced low rectal cancer suggest that clinical parameters have a role in predicting sphincter-preserving surgery.

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Factors affecting sphincter-preserving resection treatment for patients with low rectal cancer

Cited by 12 publications

References 35 publications

Anal function and quality of life analysis after laparoscopic modified Parks for ultra-low rectal cancer patients

Anal function and quality of life analysis after laparoscopic modified Parks for ultra-low rectal cancer patients

Clinical parameters predictive for sphincter-preserving surgery and prognostic outcome in patients with locally advanced low rectal cancer

Clinical parameters predictive for sphincter-preserving surgery and prognostic outcome in patients with locally advanced low rectal cancer

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